The role of chest computed tomography in the management of COVID-19: A review of results and recommendations

The rapid and dramatic increase in confirmed cases of COVID-19 has led to a global pandemic. Early detection and containment are currently the most effective methods for controlling the outbreak. A positive diagnosis is determined by laboratory real-time reverse transcriptase polymerase chain reaction (rRT-PCR) testing, but the use of chest computed tomography (CT) has also been indicated as an important tool for detection and management of the disease. Numerous studies reviewed in this paper largely concur in their findings that the early hallmarks of COVID-19 infection are ground-glass opacities (GGOs), often with a bilateral and peripheral lung distribution. In addition, most studies demonstrated similar CT findings related to the progression of the disease, starting with GGOs in early disease, followed by the development of crazy paving in middle stages and finally increasing consolidation in the later stages of the disease. Studies have reported a low rate of misdiagnosis by chest CT, as well as a high rate of misdiagnosis by the rRT-PCR tests. Specifically, chest CT provides more accurate results in the early stages of COVID-19, when it is critical to begin treatment as well as isolate the patient to avoid the spread of the virus. While rRT-PCR will probably remain the definitive final test for COVID-19, until it is more readily available and can consistently provide higher sensitivity, the use of chest CT for early stage detection has proven valuable in avoiding misdiagnosis as well as monitoring the progression of the disease. With the understanding of the role of chest CT, researchers are beginning to apply deep learning and other algorithms to differentiate between COVID-19 and non-COVID-19 CT scans, determine the severity of the disease to guide the course of treatment, and investigate numerous additional COVID-19 applications. Impact statement The impact of the COVID-19 pandemic has been worldwide, and clinicians and researchers around the world have been working to develop effective and efficient methods for early detection as well as monitoring of the disease progression. This minireview compiles the various agency and expert recommendations, along with results from studies published in numerous countries, in an effort to facilitate the research in imaging technology development to benefit the detection and monitoring of COVID-19. To the best of our knowledge, this is the first review paper on the topic, and it provides a brief, yet comprehensive analysis.

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Correlation between age, sex, and severity of Coronavirus disease-19 based on chest computed tomography severity scoring system

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-021-00408-1 ◽

2021 ◽

Vol 52 (1) ◽

Author(s):

Shimaa Farghaly ◽

Marwa Makboul

Keyword(s):

Computed Tomography ◽

Scoring System ◽

Fatal Outcome ◽

Age Groups ◽

Significant Risk ◽

Chest Ct ◽

Age Group ◽

Severity Scoring ◽

Chest Computed Tomography ◽

Severity Of The Disease

Abstract Background Coronavirus disease 2019 (COVID-19) is the most recent global health emergency; early diagnosis of COVID-19 is very important for rapid clinical interventions and patient isolation; chest computed tomography (CT) plays an important role in screening, diagnosis, and evaluating the progress of the disease. According to the results of different studies, due to high severity of the disease, clinicians should be aware of the different potential risk factors associated with the fatal outcome, so chest CT severity scoring system was designed for semi-quantitative assessment of the severity of lung disease in COVID-19 patients, ranking the pulmonary involvement on 25 points severity scale according to extent of lung abnormalities; this study aims to evaluate retrospectively the relationship between age and severity of COVID-19 in both sexes based on chest CT severity scoring system. Results Age group C (40–49 year) was the commonest age group that was affected by COVID-19 by 21.3%, while the least affected group was group F (≥ 70 years) by only 6.4%. As regards COVID-RADS classification, COVID-RADS-3 was the most commonly presented at both sexes in all different age groups. Total CT severity lung score had a positive strong significant correlation with the age of the patient (r = 0.64, P < 0.001). Also, a positive strong significant correlation was observed between CT severity lung score and age in both males and females (r = 0.59, P < 0.001) and (r = 0.69, P < 0.001) respectively. Conclusion We concluded that age can be considered as a significant risk factor for the severity of COVID-19 in both sexes. Also, CT can be used as a significant diagnostic tool for the diagnosis of COVID-19 and evaluation of the progression and severity of the disease.

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A Pilot Study to Estimate the Impact of High Matrix Image Reconstruction on Chest Computed Tomography

Journal of Clinical Imaging Science ◽

10.25259/jcis_143_2021 ◽

2021 ◽

Vol 11 ◽

pp. 52

Author(s):

Akitoshi Inoue ◽

Tucker F. Johnson ◽

Benjamin A. Voss ◽

Yong S. Lee ◽

Shuai Leng ◽

...

Keyword(s):

Computed Tomography ◽

Image Reconstruction ◽

Pulmonary Nodules ◽

Chest Ct ◽

Imaging Findings ◽

Chest Computed Tomography ◽

Matrix Image ◽

High Matrix ◽

The Impact

Objectives: The objectives of the study were to estimate the impact of high matrix image reconstruction on chest computed tomography (CT) compared to standard image reconstruction. Material and Methods: This retrospective study included patients with interstitial or parenchymal lung disease, airway disease, and pulmonary nodules who underwent chest CT. Chest CT images were reconstructed using high matrix (1024 × 1024) or standard matrix (512 × 512), with all other parameters matched. Two radiologists, blinded to reconstruction technique, independently examined each lung, viewing image sets side by side and rating the conspicuity of imaging findings using a 5-point relative conspicuity scale. The presence of pulmonary nodules and confidence in classification of internal attenuation was also graded. Overall image quality and subjective noise/artifacts were assessed. Results: Thirty-four patients with 68 lungs were evaluated. Relative conspicuity scores were significantly higher using high matrix image reconstruction for all imaging findings indicative of idiopathic lung fibrosis (peripheral airway visualization, interlobular septal thickening, intralobular reticular opacity, and end-stage fibrotic change; P ≤ 0.001) along with emphysema, mosaic attenuation, and fourth order bronchi for both readers (P ≤ 0.001). High matrix reconstruction did not improve confidence in the presence or classification of internal nodule attenuation for either reader. Overall image quality was increased but not subjective noise/artifacts with high matrix image reconstruction for both readers (P < 0.001). Conclusion: High matrix image reconstruction significantly improves the conspicuity of imaging findings reflecting interstitial lung disease and may be useful for diagnosis or treatment response assessment.

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The Role of Chest Computed Tomography in Asymptomatic Patients of Positive Coronavirus Disease 2019: A Case and Literature Review

Journal of Clinical Imaging Science ◽

10.25259/jcis_58_2020 ◽

2020 ◽

Vol 10 ◽

pp. 35 ◽

Cited By ~ 1

Author(s):

Jeton Shatri ◽

Lirim Tafilaj ◽

Agon Turkaj ◽

Kreshnike Dedushi ◽

Metë Shatri ◽

...

Keyword(s):

Computed Tomography ◽

Early Detection ◽

Severe Acute Respiratory Syndrome ◽

Literature Review ◽

Primary Source ◽

Travel History ◽

Chest Computed Tomography ◽

Source Of Infection ◽

Asymptomatic Patients

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an ongoing global health emergency. At present, patients are the primary source of infection. A randomly diagnosed confirmed case of COVID-19 highlights the importance of computerized tomography of thorax in diagnosing asymptomatic patients. In the early phase of COVID-19, routine screenings miss patients who are virus carriers, and tracking travel history is of paramount importance to early detection and isolation of SARS-CoV-2 cases.

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Chest computed tomography and chest X-ray in the diagnosis of community-acquired pneumonia: a retrospective observational study

Journal of International Medical Research ◽

10.1177/03000605211039791 ◽

2021 ◽

Vol 49 (8) ◽

pp. 030006052110397

Author(s):

Dima Ibrahim ◽

Abdul Rahman Bizri ◽

Mohammad Ali El Amine ◽

Zeina Halabi

Keyword(s):

Computed Tomography ◽

Medical Records ◽

Community Acquired Pneumonia ◽

Chest Ct ◽

Chest Computed Tomography ◽

X Ray ◽

Combined Use ◽

Chest X Ray ◽

Large Benefit ◽

The Impact

Objectives To compare the yield of early combined use of chest X-ray (CXR) and chest computed tomography (CT) in patients diagnosed with community-acquired pneumonia (CAP) presenting to the emergency department (ED) and assess the impact of chest CT on the initial diagnosis. Methods The medical records of 900 patients who presented to the ED and were diagnosed with CAP over a 1-year period were reviewed, and 130 patients who underwent CXR and chest CT within 48 hours were selected. CXR findings were classified as positive, negative, or inconclusive for CAP. Chest CT findings were defined as positive, negative, inconclusive, or positive with add-on to the CXR findings. CT was classified as having no benefit, large benefit, or moderate benefit based on the chest CT and CXR findings. Results Chest CT results were positive in 90.7% of patients, with 41.5% being newly diagnosed after negative or inconclusive CXR and 21.5% being diagnosed with add-on to the CXR findings. CT had large, moderate, and no benefit over CXR in diagnosing or excluding CAP in 45.3%, 21.5%, and 33.1% of patients, respectively. Conclusion Early chest CT may be used to compliment CXR in the early diagnosis of CAP among patients in the ED.

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Exploring the effectiveness of a COVID-19 contact tracing app using an agent-based model

Scientific Reports ◽

10.1038/s41598-020-79000-y ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Jonatan Almagor ◽

Stefano Picascia

Keyword(s):

High Rate ◽

Contact Tracing ◽

Agent Based Model ◽

Agent Based ◽

The Social ◽

Behavioural Factors ◽

The Impact ◽

Different Levels ◽

User Rate

AbstractA contact-tracing strategy has been deemed necessary to contain the spread of COVID-19 following the relaxation of lockdown measures. Using an agent-based model, we explore one of the technology-based strategies proposed, a contact-tracing smartphone app. The model simulates the spread of COVID-19 in a population of agents on an urban scale. Agents are heterogeneous in their characteristics and are linked in a multi-layered network representing the social structure—including households, friendships, employment and schools. We explore the interplay of various adoption rates of the contact-tracing app, different levels of testing capacity, and behavioural factors to assess the impact on the epidemic. Results suggest that a contact tracing app can contribute substantially to reducing infection rates in the population when accompanied by a sufficient testing capacity or when the testing policy prioritises symptomatic cases. As user rate increases, prevalence of infection decreases. With that, when symptomatic cases are not prioritised for testing, a high rate of app users can generate an extensive increase in the demand for testing, which, if not met with adequate supply, may render the app counterproductive. This points to the crucial role of an efficient testing policy and the necessity to upscale testing capacity.

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The Impact of Chest Computed Tomography in a COVID-19 Reference Hospital - First Wave - Distrito Federal - Brazil

SSRN Electronic Journal ◽

10.2139/ssrn.4005199 ◽

2022 ◽

Author(s):

Gleim Dias de Souza ◽

Luciana Rodrigues Queiroz de Souza ◽

Gabriela Gomes de Souza ◽

Thales Queiroz Souza ◽

Ulysses Rodrigues Castro ◽

...

Keyword(s):

Computed Tomography ◽

Chest Computed Tomography ◽

Reference Hospital ◽

Distrito Federal ◽

The Impact

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Feasible Dose Reduction in Routine Chest Computed Tomography Maintaining Constant Image Quality Using the Last Three Scanner Generations: From Filtered Back Projection to Sinogram-affirmed Iterative Reconstruction and Impact of the Novel Fully Integrated Detector Design Minimizing Electronic Noise

Journal of Clinical Imaging Science ◽

10.4103/2156-7514.137826 ◽

2014 ◽

Vol 4 ◽

pp. 38 ◽

Cited By ~ 12

Author(s):

Lukas Ebner ◽

Felix Knobloch ◽

Adrian Huber ◽

Julia Landau ◽

Daniel Ott ◽

...

Keyword(s):

Computed Tomography ◽

Soft Tissue ◽

Radiation Dose ◽

Dose Reduction ◽

Integrated Circuit ◽

Chest Ct ◽

Back Projection ◽

Dose Length Product ◽

Chest Computed Tomography ◽

Tube Current

Objective: The aim of the present study was to evaluate a dose reduction in contrast-enhanced chest computed tomography (CT) by comparing the three latest generations of Siemens CT scanners used in clinical practice. We analyzed the amount of radiation used with filtered back projection (FBP) and an iterative reconstruction (IR) algorithm to yield the same image quality. Furthermore, the influence on the radiation dose of the most recent integrated circuit detector (ICD; Stellar detector, Siemens Healthcare, Erlangen, Germany) was investigated. Materials and Methods: 136 Patients were included. Scan parameters were set to a thorax routine: SOMATOM Sensation 64 (FBP), SOMATOM Definition Flash (IR), and SOMATOM Definition Edge (ICD and IR). Tube current was set constantly to the reference level of 100 mA automated tube current modulation using reference milliamperes. Care kV was used on the Flash and Edge scanner, while tube potential was individually selected between 100 and 140 kVp by the medical technologists at the SOMATOM Sensation. Quality assessment was performed on soft-tissue kernel reconstruction. Dose was represented by the dose length product. Results: Dose-length product (DLP) with FBP for the average chest CT was 308 mGy*cm ± 99.6. In contrast, the DLP for the chest CT with IR algorithm was 196.8 mGy*cm ± 68.8 (P = 0.0001). Further decline in dose can be noted with IR and the ICD: DLP: 166.4 mGy*cm ± 54.5 (P = 0.033). The dose reduction compared to FBP was 36.1% with IR and 45.6% with IR/ICD. Signal-to-noise ratio (SNR) was favorable in the aorta, bone, and soft tissue for IR/ICD in combination compared to FBP (the P values ranged from 0.003 to 0.048). Overall contrast-to-noise ratio (CNR) improved with declining DLP. Conclusion: The most recent technical developments, namely IR in combination with integrated circuit detectors, can significantly lower radiation dose in chest CT examinations.

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A Study of the Impact of Cloud Computing Alignment on the Enterprise Technological Capability Based on Environmental Turbulence

E3S Web of Conferences ◽

10.1051/e3sconf/202123502049 ◽

2021 ◽

Vol 235 ◽

pp. 02049

Author(s):

MingXing Shao ◽

XiaoHe Yang

Keyword(s):

Cloud Computing ◽

Industrial Development ◽

Technology Development ◽

Environmental Turbulence ◽

High Tech ◽

Enterprise Technology ◽

Technology Absorption ◽

The Impact ◽

Development Capability

One of the most current concerns in the field of information system is whether cloud computing technology can deliver the desired improvement of capability and value to enterprises. This paper studied the enterprise technology development capability of the enterprises in Beijing Zhongguancun Technology Park, the first national high-tech industrial development zone in China, from the perspective of the breadth and depth of the alignment of cloud computing and enterprise. It proposed a theoretical model to study how the breadth and depth of alignment affects the enterprise technology development capability in a turbulent environment and considers the intermediary role of the enterprise technology absorption capability and the moderation role of environmental turbulence in it. The model was tested empirically by questionnaires and structural equation model (SEM). Empirical results showed that both the deep and wide alignment of cloud computing can enhance the enterprise technology development capability by improving the enterprise technology absorption capability.

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